2型糖尿病患者交感皮肤反应、神经传导速度与空腹血清C肽、FGF21、补体因子B水平相关性研究

Relationship between sympathetic skin reaction,nerve conduction velocity and fasting serum C-peptide,FGF21,complement factor B levels in 2 diabctes mellitus patients.

目的研究2型糖尿病患者交感皮肤反应(SSR)、神经传导速度(NCV)与空腹血清C肽(C-P)、成纤维细胞生长因子21(FGF21)、补体因子B(CFB)水平之间的相关性。方法回顾性选取2020年3月至2021年5月北京中医药大学东方医院收治的2型糖尿病患者122例,按照SSR的不同分为SSR正常组67例,SSR异常组55例;按照NCV的不同分为NCV正常组64例,NCV异常组58例。比较不同SSR、NCV组的病程、C肽、FGF21、CFB、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)情况;采用多因素Logistic回归分析影响SSR、NCV异常的危险因素。结果SSR正常组患者的病程、FGF21、CFB、2 hPG显著低于SSR异常组,C肽显著高于SSR异常组,差异均有统计学意义(P<0.05),两组HbA1c比较差异无统计学意义(P>0.05)。SSR正常组患者的病程、FGF21、CFB、HbA1c、2 hPG显著低于SSR异常组,C肽显著高于SSR异常组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析,结果显示病程、血清C肽、FGF21、CFB、2 hPG均为SSR异常的独立危险因素(P<0.05);病程、血清C肽、FGF21、CFB、2 hPG、HbA1c均为NCV异常的独立危险因素(P<0.05)。结论血清C肽、FGF21、CFB与2型糖尿病患者合并周围神经病变的病情密切相关,对血清C肽、FGF21、CFB进行监测可帮助神经病变的早期诊断。

Objective To investigate the correlation between sympathetic skin reaction(SSR),nerve conduction velocity(NCV)and fasting serum C-peptide(C-P),fibroblast growth factor 21(FGF21),complement factor B(CFB)levels in patients with type 2 diabetes mellitus(T2DM).Methods A total of 122 patients with T2DM included in Dongfang Hospital,Beijing University of Chinese Medicine from March 2020 to May 2021 were selected and divided into SSR normal group(n=67),SSR abnormal group(n=55)according to different SSR;and were divided into NCV normal group(n=64)and NCV abnormal group(n=58)according to different NCV.The disease course,C-peptide,FGF21,CFB,glycosylated hemoglobin(HbA1c),and 2 h postprandial blood glucose(2 hPG)in different SSR and NCV groups were compared.Risk factors affecting SSR and NCV abnormalities were analyzed using multivariate Logistic regression analysis.Results The course of disease,FGF21,CFB and 2 hPG in the normal SSR group were significantly lower than those in the abnormal SSR group,and C-P was significantly higher than that in the abnormal SSR group,the differences were statistically significant(P<0.05);there was no significant difference in HbA1c between the two groups(P>0.05).The disease duration,FGF21,CFB,HbA1c,and 2 hPG of patients in the normal SSR group were significantly lower than those in the abnormal SSR group,and C-P was significantly higher than that in the abnormal SSR group,the differences were statistically significant(P<0.05).According to multivariate Logistic regression analysis,disease duration,serum C-P,FGF21,CFB,and 2 hPG were all independent risk factors for SSR abnormalities(P<0.05).Disease duration,serum C-P,FGF21,CFB,2 hPG,and HbA1c were all independent risk factors for abnormal NCV(P<0.05).Conclusion Serum C-P,FGF21 and CFB are closely related to the condition of T2DM patients with peripheral neuropathy.Monitoring serum C-P,FGF21 and CFB can help the early diagnosis of neuropathy.